CT of Benign Hypervascular Liver Nodules in Autoimmune Hepatitis

Department of Medicine, University of California, San Francisco, San Francisco, California, United States
American Journal of Roentgenology (Impact Factor: 2.73). 01/2005; 183(6):1573-6. DOI: 10.2214/ajr.183.6.01831573
Source: PubMed


OBJECTIVE: The purpose of this report is to describe the frequency and histopathologic basis of benign hypervascular liver nodules seen on CT in patients with autoimmune hepatitis. CONCLUSION: Benign hypervascular liver nodules may be seen on CT in patients with cirrhosis due to autoimmune hepatitis and may represent large regenerative nodules. This phenomenon is important to recognize because of the potential for confusion with hepatocellular carcinoma.

20 Reads
  • [Show abstract] [Hide abstract]
    ABSTRACT: To retrospectively describe imaging analyses of benign hypervascular hyperplastic liver nodules (HHN) that resulted from alcoholic liver cirrhosis and to examine the possibility of imaging differentiation between these nodules and hypervascular hepatocellular carcinoma (HCC). Ten histopathologically confirmed HHN arise in alcoholic liver cirrhosis, and 9 HCC were examined. Magnetic resonance imaging (MRI) (10 HHN and 9 HCC), superparamagnetic iron oxide-enhanced T2-weighted MRI (6 HHN and 4 HCC), and dual-phase computed tomography hepatic arteriography (5 HHN and 6 HCC) were performed, respectively. On T1-weighted magnetic resonance images, 7 HHNs showed hyperintensity and 3 showed iso- to hypointensity, and all HCCs showed hypointensity compared with surrounding liver. On T2-weighted magnetic resonance images, 2 HHNs showed hyperintensity and 8 showed iso- to hypointensity. In contrast, 1 HCC showed hypointensity and 8 showed hyperintensity. On superparamagnetic iron oxide-enhanced T2 MRI, all HHNs showed iso- to hypointensity, and all HCCs showed hyperintensity. All HHN and HCCs subjected to dual-phase computed tomography hepatic arteriography showed enhancement on early-phase images and coronalike enhancement on late-phase images. Imaging findings of highly-well differentiated HCCs possibly overlap with HHN. So, for correct diagnosis of HHN, at first, we should suspect HHN based on clinical findings and MRI findings, and then perform core needle biopsy to verify the radiological diagnosis.
    No preview · Article · Jul 2007 · Journal of Computer Assisted Tomography
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Cirrhotic livers are characterized by advanced fibrosis and the formation of hepatocellular nodules, which are classified histologically as either (a) regenerative lesions (eg, regenerative nodules, lobar or segmental hyperplasia, focal nodular hyperplasia) or (b) dysplastic or neoplastic lesions (eg, dysplastic foci and nodules, hepatocellular carcinomas). The differentiation of these lesions is important because regenerative nodules are benign, whereas dysplastic and neoplastic nodules are premalignant and malignant, respectively. However, their accurate characterization may be difficult even at histopathologic analysis. Differential diagnosis may be facilitated by comparing the clinical and pathologic findings with radiologic imaging features; in particular, nodule size, vascularity, hepatocellular function, and Kupffer cell density assessed at magnetic resonance (MR) imaging are suggestive of the correct diagnosis. MR imaging is more useful than computed tomography for such assessments because it provides better soft-tissue contrast and a more nuanced depiction of different tissue properties. Moreover, a wider variety of contrast agents is available for use in MR imaging. Familiarity with the MR imaging characteristics of cirrhosis-associated hepatocellular nodules is therefore important for optimal diagnosis and management of cirrhotic disease.
    Preview · Article · May 2008 · Radiographics
  • [Show abstract] [Hide abstract]
    ABSTRACT: To describe the CT and MRI features of autoimmune hepatitis (AIH) and correlate them with histological grade and stage. Observed changes associated with treatment are also described. A retrospective analysis of the initial CT scans (n = 22) and MRI exams (n = 12) of 27 patients with pathologically-proven AIH was conducted. Multiple objective and subjective imaging features were evaluated. Correlation of imaging features with histological inflammatory grade and fibrotic stage was performed using the Fisher exact test and Spearman's rank correlation coefficient. In eight patients serial CT and MR imaging during treatment was used to describe the changes associated with treatment. The presence of ascites, expanded gallbladder fossa, spleen size, and enlarged preportal space had significant positive correlations with fibrotic stage. No significant positive correlations existed between imaging features and portal or lobular inflammatory grade. Seven patients (25.9%) were normal. The most common abnormal finding was surface nodularity: CT (n = 11 [50%]) and MRI (n = 8 [66.7%]). There was a wide variability in imaging appearances of patients who had serial scans on treatment. There is a wide spectrum of CT and MR imaging features in patients with AIH. Several MRI features demonstrate a significant positive correlation with fibrotic stage.
    No preview · Article · Jan 2009 · Abdominal Imaging
Show more